Johannes Erdmann

Technische Universität München, München, Bavaria, Germany

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Publications (56)86.75 Total impact

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    ABSTRACT: Aims: Measurements of resting energy expenditure (REE) were compared with the data of 14 equations to determine their accuracy. Methods: REE measurements by indirect calorimetry in 1,032 unselected overweight and obese men (n = 306) and women (n = 726) were compared with calculations by 14 different formulas. Results: The mean (± SD) values calculated with the Owen, Robertson and Reid and WHO-I equations were not significantly different from our measurement of 1,682 ± 441.9 kcal/24 h. The values obtained with the Livingston, Mifflin, Müller and Bernstein equations were significantly different but still within a range of ±100 kcal/24 h. For females, the best comparison was observed with the Müller equation which, however, differed substantially in males. For men, the Cunningham equation was best, but it gave the worst comparison in women. A good individual match was only obtained with the equation of Robertson and Reid in 34% of the men and with the Owen equation in 38% of the women. All other formulas were less accurate. Drug treatment for 55% of the subjects had no effect on the mismatch between calculated and measured data. Conclusion: Calculations of REE with most equations seem to be valid in a group analysis but they are not helpful for the estimation of an obese patient's individual energy expenditure. © 2014 S. Karger AG, Basel.
    Annals of Nutrition and Metabolism 10/2014; 65(4):299-309. · 1.66 Impact Factor
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    ABSTRACT: Weight gain and obesity are of substantial importance for the development of insulin-resistance and type-2 diabetes mellitus. Fetuin-A, a liver-derived glycoprotein, may also play a role in these alterations. Several studies have demonstrated an association between fetuin-A and body weight which, however, was within a fairly small range at the border of overweight to obesity. The present study examines the relationship between fetuin-A and a wide range of BMI, together with basal insulin, and HOMA-IR. In addition, matched groups of non-diabetic patients and those with type-2 diabetes mellitus were compared. We examined the relationship between fetuin-A and BMI, insulin, HOMA-IR, glucose and HbA1c in a cohort of 445 non-diabetic obese subjects and 150 obese patients with type-2-diabetes mellitus (DM2). In relation to quintiles of fetuin-A a significant increase of BMI, basal insulin and HOMA-IR was observed between the 1st and 2nd quintile with no further change thereafter. Correspondingly, fetuin-A levels increased significantly only between the 1st and 2nd quintile of BMI, insulin or HOMA-IR, respectively. When patients with type 2 diabetes were compared with non-diabetic subjects matched for BMI, insulin, and age median fetuin-A levels were not significantly different. At the early stage of weight gain fetuin-A could be of relevance for the development of insulin resistance. For the further progressive resistance with increasing weight in the obesity range the present data do not support a role of fetuin-A. Similarly its contribution to the resistance of type-2 diabetes seems to be of minor importance.
    Regulatory Peptides 02/2012; 178(1-3):6-10. · 2.06 Impact Factor
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    ABSTRACT: Hyperinsulinemia of nondiabetic overweight and obese subjects is associated with weight-dependent increased insulin secretion and decreased insulin clearance. The present analysis examines whether similar effects can be observed in overweight and obese patients with type 2 diabetes mellitus (DM2). Additionally basal and postprandial insulin secretion and clearance were analyzed in relation to duration of disease. In a random sample of 348 DM2 patients basal plasma insulin concentrations were significantly higher in most BMI groups compared to matched nondiabetic (ND) controls. The weight-dependent increase of basal insulin in DM2 was primarily the result of reduced clearance rather than augmented secretion. Postprandial insulin concentrations were lower in DM2 patients and did not show any BMI-related increase. The weight-dependent reduction of postprandial insulin clearance was absent in DM2. At the time of diagnosis basal insulin concentration was higher and secretion was comparable to ND subjects and this did not change with duration of diabetes. The early postprandial insulin response was still comparable between DM2 and ND subjects at the time of diagnosis but deteriorated with longer duration of disease. The later postprandial response at diagnosis (AUC 90-180) was characterized by significantly greater insulin secretion and concentration while later on the 3-fold higher secretion was paralleled by comparable peripheral plasma concentrations due to a significantly greater postprandial insulin clearance in DM2. In conclusion, the present data indicate that apart from disturbances of insulin secretion substantial changes of insulin clearance contribute to inadequate peripheral insulin concentrations in obese DM2 patients.
    Hormone and Metabolic Research 01/2012; 44(1):60-9. · 2.15 Impact Factor
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    ABSTRACT: Ghrelin is the only peripheral orexigenic peptide of gastrointestinal origin. Its preprandial increase is supposed to initiate food intake. This assumption is based on studies with intravenously infused ghrelin in rather high doses and the correlation between ghrelin levels and hunger sensations. As yet it is unclear whether or not low dose ghrelin resulting in physiological and moderately supraphysiological plasma levels has an effect on hunger sensations, the wish for food intake and / or the quantity of the meal consumed. We examined 20 normal-weight males (age 25±1.7 years, BMI 24±0.5 kg/m(2)) in a prospective double-blind randomized fashion. On two different days they obtained a ghrelin infusion 1 ng/kg/min or intravenous saline starting one hour after a standardized meal. Hunger and satiety ratings were documented by visual analogue scales. A second meal was served on demand and consumed until feeling satiated. Time point of the second meal as well as ingested calories were registered. Prior to the start of i.v. ghrelin the postprandial decrease of active plasma ghrelin by 30 pg/ml was comparable. In the controls the postprandial reduction was significant until 210 min compared to basal. With i.v. ghrelin basal levels were reached within 10 min. The maximal rise was twice basal. No effect was observed on hunger and satiety ratings. The time period between the meals and the food quantity of the second meal were similar. During ghrelin infusion glucose and growth hormone but not insulin and cortisol levels were significantly higher after the second meal compared to saline. The present data demonstrate for the first time the effect of a low dose ghrelin infusion on food intake. Neither physiological nor moderably supraphysiological ghrelin levels were associated with any change of the various food intake parameters determined. These data do not favour a hormonal role of peripheral ghrelin in the regulation of food intake.
    Regulatory Peptides 11/2011; 174(1-3):26-31. · 2.06 Impact Factor
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    ABSTRACT: The role of breakfast energy in total daily energy intake is a matter of debate. Acute feeding experiments demonstrated that high breakfast energy leads to greater overall intake supported by cross-sectional data of a free-living population. On the other hand, a large intraindividual analysis has indicated that a high proportion of breakfast to overall intake is associated with lower daily energy intake. To evaluate these apparently contradictory results in greater detail both ways of analysis were applied to the same data set of dietary records. On an intraindividual basis total daily energy intake was related to the absolute values of breakfast energy intake or to the ratio of breakfast to overall intake, respectively. Food intake of 280 obese and 100 normal weight subjects was analyzed who recorded over 10 (obese) or 14 (normal weight) consecutive days, respectively. Increasing breakfast energy was associated with greater overall intake in normal weight and obese subjects. The increasing ratio of breakfast to total daily energy intake was associated with a significant reduction of overall intake on days where post-breakfast energy was significantly reduced. Correlational and multiple regression analysis support the concept that absolute breakfast calories have the strongest influence on daily energy intake. Reduced breakfast energy intake is associated with lower total daily intake. The influence of the ratio of breakfast to overall energy intake largely depends on the post-breakfast rather than breakfast intake pattern. Therefore, overweight and obese subjects should consider the reduction of breakfast calories as a simple option to improve their daily energy balance.
    Nutrition Journal 01/2011; 10:5. · 2.65 Impact Factor
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    ABSTRACT: Weight change was analyzed in a cohort of obese patients whose eating habits were changed individually mainly on the basis of food energy density (ED) to evaluate the feasibility of this concept for a larger controlled trial. Five hundred and thirteen outpatients were treated between January 2003 and December 2006. Dietary counseling was based on a pretreatment food diary. In January 2008, a follow-up (FU) was made. For pre- and post-change eating habits, 5184 dietary protocols of 189 patients were analyzed. During 10.5 months of treatment, patients lost weight from an initial BMI of 38.8 ± 8.5 by -0.195 kg/m(2) per month; 36% had weight loss >5%, 44% lost 0-4.9% and 20% had weight gain. At follow-up, 413 patients (80.5%) were reached of whom 80 were still in treatment while 333 were considered as self-treatment (ST) group. The ST group had further weight loss by -0.053 kg/m(2) per month over 16.8 months (40% weight loss, 46% maintenance and 14% weight gain), and 164 patients with type-2-diabetes had greater weight loss compared to those without diabetes during ST (Δ-BMI-0.166 vs. -0.028 points/month; p < 0.0001). Energy intake (EI) was reduced by lower ED, beverages and number of meals. Average carbohydrate, fat and protein intake was reduced by 28, 42, and 7%, respectively. In a unselected cohort of substantially obese patients, the individual change of eating habits based primarily on food ED in conjunction with beverage intake and meal frequency weight loss continued beyond the supported treatment phase indicating a good patient adherence. We consider these data as an encouraging pilot study that certainly requires confirmation under controlled conditions.
    European Journal of Nutrition 12/2010; 50(5):351-61. · 3.13 Impact Factor
  • Volker Schusdziarra, Johannes Erdmann
    Gastroenterologie up2date 09/2010; 6(03):211-231.
  • J Erdmann, S Tholl, V Schusdziarra
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    ABSTRACT: Exercise is an important part of obesity treatment concepts to support fat mobilisation from adipose tissue and also fat oxidation nolich is impaired in obese subjects. In normal weight subjects it is well known that stimulation of plasma insulin levels by a carbohydrate meal can inhibit lipolysis and subsequent fat oxidation. Since obese subjects frequently have elevated basal and postprandial insulin levels the effect of carbohydrate- and protein-rich test meals on exercise-induced activation of lipolysis is of special interest. Twenty obese subjects performed bicycle exercise for 30 min in the fasted state, 30 min after a carbohydrate-or a protein-rich meal, and 120 min after the carbohydrate meal (n=12), respectively, at low intensity. Activation of lipolysis was assessed by plasma glycerol levels. In addition, plasma insulin, glucose, and lactate concentrations were determined. In comparison to the fasted state, the carbohydrate meal suppressed activation of lipolysis. Following the protein meal, exercise led to an attenuated but significant increase of glycerol levels. A similar rise was observed when the carbohydrate meal was ingested 2 h prior to the exercise bout. To improve exercise-induced lipolysis and subsequent fat oxidation during low-intensity exercise obese subjects should not ingest carbohydrates immediately before exercise. Hunger sensations should be satisfied with protein-rich food. When carbohydrates are consumed 2 h prior to exercise its lipolytic effect is comparable to the protein meal. These data are useful in every day dietary counselling and might help to improve weight loss during obesity treatment.
    Hormone and Metabolic Research 04/2010; 42(4):290-4. · 2.15 Impact Factor
  • Aktuelle Ernährungsmedizin 02/2010; 35(01).
  • Zeitschrift Fur Gastroenterologie - Z GASTROENTEROL. 01/2010; 48(08).
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    ABSTRACT: The role of the orexigenic hormone ghrelin is of major interest in the altered appetite regulation of the elderly. Basal and postprandial levels of active and total ghrelin were measured in 15 younger (mean age 35.4 years) and 19 older (80.7 years) participants following a carbohydrate-rich test meal. Our results showed that older participants felt postprandially less hungry and more full. Although basal levels were not significantly different, active and total ghrelin levels declined postprandially only in the younger study participants. Highly significant differences between the two age groups were shown for the changes of the area under the curve for active ghrelin (p = .024). Our study demonstrates for the first time that differences in hunger and satiety sensations in relation to age are paralleled by a substantially different response of acylated and total ghrelin, that is, the absence of a postprandial decline in ghrelin levels.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 11/2009; 65(3):307-11. · 4.31 Impact Factor
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    ABSTRACT: In normal weight subjects it is known that day-to-day energy intake (EI) can vary substantially while this question has not been examined in obese subjects. From acute feeding experiments one would assume that these perturbations are mainly due to differences in food energy density (ED). However, food quantity (FQ) during single meals, number of meals, cognitive and sensory mechanisms may also contribute to the modification of EI. To obtain more detailed information about day-to-day variations of food intake food diaries recorded during 10 consecutive days of 280 obese and 100 normal weight subjects were examined. The chronological analysis shows a fairly constant pattern for EI, FQ and ED in both groups. The group analysis, however, masks individual fluctuations since the coefficients of variation were between 20 and 24% for the three parameters, respectively. This corresponds to a range of 1,200 kcal. Sixty-five percent can be accounted for changes in FQ and 35% as the result of variations in ED. Snacks between main meals account for 20% of daily EI but only 10% of FQ. Furthermore, snack EI is not compensated during main meals. Small day-to-day changes of EI are due to increased meal quantities while greater fluctuations are also due to higher food ED. The present data suggest that modification of FQ by cognitive and sensory factors plays an important role in the variation of daily EI under real life conditions with no major difference between normal weight and obese subjects.
    European Journal of Nutrition 09/2009; 49(1):37-43. · 3.13 Impact Factor
  • 01/2009;
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    ABSTRACT: Obesity is associated with insulin resistance and the resulting hyperinsulinemia has been attributed to an increase of insulin secretion and a reduction of insulin clearance. The present study was intended to further characterize the relative contribution of secretion and clearance especially in the postprandial state. In relation to WHO body weight classes 291 subjects were divided in 5 subgroups Basal insulin concentrations rose stepwise and significantly with increasing BMI. This was paralleled by C-peptide concentrations and insulin secretion, while the reduction of insulin clearance was less stringent in relation to BMI. Basal glucose was unchanged in the BMI25 group and 8% higher in the obese groups (BMI 30, 35, 40) compared to normal weight (NW). Although postprandial insulin concentrations were significantly higher in the overweight and obese groups compared to NW the correlation was not as tight as in the basal state. Furthermore, the present data demonstrate for the first time that insulin secretion only increased in the overweight group without further augmentation in the obese groups. Further hyperinsulinemia of the latter was due to weight-dependent reduction of insulin clearance. The postprandial glucose response was 38-82% higher with increasing weight compared to NW. In summary basal hyperinsulinemia is mainly due to weight related increase of insulin secretion with moderate contribution of reduced insulin clearance. Postprandially, hyperinsulinemia of overweight is predominantly due to secretion while further postprandial hyperinsulinemia of obese subjects is mainly due to reduced clearance. Thus, postprandial insulin secretion cannot respond adequately to the challenge of weight-dependent insulin resistance already in non-diabetic obese subjects.
    Regulatory Peptides 12/2008; 152(1-3):1-7. · 2.06 Impact Factor
  • MMW Fortschritte der Medizin 08/2008; 150(28-31):55-7.
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    ABSTRACT: Obestatin is supposed to be involved in nutrient homeostasis. Therefore, basal plasma obestatin levels were investigated in 321 normal weight and obese subjects in relation to body mass index, gender, age, insulin concentrations, and type 2 diabetes mellitus. Additionally, postprandial obestatin levels were determined in 20 normal weight subjects. Basal obestatin levels in females were higher compared to males (193.6+/-5.8 vs. 140.6+/-5.1 pg/ml). Obestatin levels correlated inversely and significantly with body mass index (f: r=-0.632, p<0.001; m: r=-0.487, p<0.001) and basal insulin levels (f: r=-0.536, p<0.001; m: r=-0.320, p=0.008) in females and males. However, in a multiple regression analysis as well as in a matched comparison of a low and high insulin group no significant relationship between insulin and obestatin levels was observed in nondiabetics. On the other hand, inclusion of type 2 diabetics with higher insulin levels resulted in a significant inverse correlation. Obestatin levels were independent of age in both sexes. In patients with type 2 diabetes mellitus basal obestatin levels were not different compared to nondiabetic subjects when matched for gender, body mass index, and insulin. In normal weight subjects, postprandial obestatin levels showed a significant decrease between 60 and 90 minutes rising to basal levels thereafter. The present data demonstrate a relation of plasma obestatin levels to body weight, gender and food intake, but not to age. The inverse relationship with insulin might depend on the level of hyperinsulinemia. The present data are compatible with a potential role of obestatin in nutrient regulation.
    Hormone and Metabolic Research 07/2008; 40(11):806-12. · 2.15 Impact Factor
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    ABSTRACT: Feeding regulation involves both anorectic and orexigenic neuropeptides mainly located in the hypothalamus. To gain further insight into the interaction between these two groups of regulators inhibition of feeding induced by glucagon-like peptide-1 (GLP-1) was examined during stimulation of food intake by equimolar doses of ghrelin and galanin. The experiments were carried out in freely feeding rats. Intracerebroventricular (i.c.v.) injections were accomplished through stereotaxically implanted cannulae aimed at the lateral cerebral ventricle. Food intake of standard rat chow pellets was subsequently recorded for 2 h. Ghrelin and galanin stimulated food intake significantly with no difference between these two peptides. During ghrelin stimulation GLP-1 inhibited feeding in doses between 0.015 and 1.5 nmol. During galanin stimulation of food intake a ten fold higher dose (0.15 nmol) was required to inhibit food intake. In conclusion equimolar doses of i.c.v. ghrelin and galanin are similarly effective stimuli of food intake when given alone. However in combination with an anorectic neuropeptide such as GLP-1 they have substantially different potencies of feeding stimulation. Such interaction could also be of interest for therapeutic strategies involving both regulating groups of neuropeptides.
    Regulatory Peptides 05/2008; 147(1-3):29-32. · 2.06 Impact Factor
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    ABSTRACT: Obesity is associated with insulin resistance and hyperinsulinemia, which is considered to be a core component in the pathophysiology of obesity-related comorbidities. As yet it is unknown whether insulin resistance and hyperinsulinemia already develop during weight gain within the normal range. In 10 healthy male subjects the effect of intentional weight gain by 2 BMI points was examined on insulin. C-peptide and glucose levels following a meal, 75 g of glucose, and a two-step hyperglycemic clamp increased plasma glucose by 1.38 and 2.75 mmol/l, respectively. Baseline insulin, C-peptide, and glucose concentrations were significantly higher after weight gain from 21.8 to 23.8 kg/m(2) BMI within 4(1/2) mo. Calculations of insulin secretion and clearance indicate that reduced insulin clearance contributes more to post-weight gain basal hyperinsulinemia than insulin secretion. Following oral or intravenous stimulation insulin concentrations were significantly higher post-weight gain during all three test conditions, whereas C-peptide and glucose levels did not differ. Calculations of insulin secretion and clearance demonstrated that higher stimulated insulin concentrations are entirely due to clearance but not secretion. Despite significantly higher insulin levels, the rate of intravenous glucose required to maintain the defined elevation of glucose levels was either identical (1.38 mmol/l) or even significantly lower (2.75 mmol/l) following weight gain. The present study demonstrates for the first time that insulin resistance already develops during weight gain within the normal range of body weight. The associated basal and stimulated hyperinsulinemia is the result of differentiated changes of insulin secretion and clearance, respectively.
    AJP Endocrinology and Metabolism 04/2008; 294(3):E568-75. · 4.51 Impact Factor
  • Clinical Nutrition Supplements 01/2008; 3:21-21.
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    ABSTRACT: Ghrelin, a recently discovered hormone of gastric origin has been shown to stimulate appetite and food intake. In man it is considered to play a role in energy homeostasis and regulation of somatropic function. As exercise affects hunger/satiety sensations and food intake, at least under some experimental conditions, we investigated the effect of exercise intensity and duration on ghrelin release and subsequent ad libitum food intake in normal weight subjects. Bicycle exercise on an ergometer for 30 min at 50 W which was below the aerob-anaerobic threshold led to an increase of ghrelin which remained unchanged during the higher intensity at 100 W. Respective hunger/satiety ratings and subsequent food intake and postprandial ghrelin suppression were identical and not different from controls. In a second group 7 subjects cycled at 50 W for 30, 60 and 120 min, respectively. Ghrelin concentrations rose significantly by 50-70 pg/ml above baseline for the respective period of exercise. While postexercise premeal ghrelin levels were not significantly different subsequent food intake after 120 min of cycling was significantly greater compared to control, 30 min and 60 min exercise, respectively. The present data suggest that low rather than high-intensity exercise stimulates ghrelin levels independent of exercise duration. Stimulation of food intake during prolonged exercise is most likely not due to changes of ghrelin.
    Regulatory Peptides 11/2007; 143(1-3):127-35. · 2.06 Impact Factor

Publication Stats

652 Citations
86.75 Total Impact Points


  • 2003–2012
    • Technische Universität München
      • • Abteilung Ernährungsmedizin
      • • Medizinische Klinik und Poliklinik III - Hämatologie/Onkologie
      München, Bavaria, Germany
  • 2008–2011
    • Ludwig-Maximilians-University of Munich
      • Department of Internal Medicine II
      München, Bavaria, Germany
  • 2009
    • Nuremberg University of Music
      Nuremberg, Bavaria, Germany
  • 2007
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      • Institute for Biomedicine of Aging
      Erlangen, Bavaria, Germany
  • 2004
    • Deutsches Herzzentrum München
      München, Bavaria, Germany